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The one thing that struck me as I walked the floor of the American Society of Anesthesiologists' annual meeting in Chicago in October was how everything keeps getting smaller, faster and more portable. The minimally invasive movement certainly has shrunk the surgeon's tools, but things have gotten leaner and meaner for us anesthesia providers, too. Pocket-sized video laryngoscopes, tablet-based ultrasound imaging systems and activated charcoal filters that provide clean anesthesia machines in less than 90 seconds were just some of the new products on display at this year's meeting.
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"BLOCK" ANESTHESIA |
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Anesthesia Machine Made of 31,238 Lego Bricks More than 130 attendees took a stab at that question in this year's ASA exhibit hall. It was there that GE Healthcare displayed a 31,238-piece Lego model of its Aisys Carestation anesthesia machine, which required a serious second look to distinguish from the real thing. The University of Texas Health Science Center at San Antonio's Benjamin Wallisch came closest to the mark with a winning guess of 31,000, and took home a copy of Anesthesia for Patients Too Sick for Anesthesia, An Issue of Anesthesiology Clinics as his prize. Eric Harshbarger is a professional Lego sculptor and builder who's used the colorful plastic bricks to craft everything from wedding cakes to a large mosaic of the New York City skyline that now hangs in Lego's Manhattan offices. But even he didn't know what to say when GE contacted him in March about constructing a model anesthesia machine. "I've been building Lego sculptures and mosaics for about 12 years, so I've gotten some strange requests. This one qualified as 'very strange,'" he says with a laugh. When GE initially approached Mr. Harshbarger, the company envisioned the sculpture as "a metaphor for showcasing the connectability, flexibility and modularity of our Aisys Carestation," says Sean Marren, GE Healthcare's strategic marketing communications manager for life support solutions — periop. "Building blocks may seem like an odd choice to promote a digital platform, but we liked the visual possibilities that this afforded us as an eye-catching display," says Mr. Marren, who reached out to Mr. Harshbarger after hearing about him from a co-worker who is a Lego enthusiast. Mr. Harshbarger "needed some convincing," he says now, but the challenge of such an intricate, detailed piece eventually swayed him. He ultimately agreed, on the condition that GE would ship an actual Carestation machine to his Auburn, Ala., home to serve as his model. Much to his surprise, GE agreed, and he began what would be a 6-month, 100-hour undertaking, accumulating the 30,000-plus necessary pieces from collectors and various Lego stores, including one in nearby Birmingham. The finished product proved worth the time and effort, with the GE booth becoming a must-visit as word of this unusual sculpture began to filter through the exhibit hall. "I heard many people exclaim 'that's awesome,' followed by the clicking sound of digital cameras. There were many international attendees at our booth — some from Denmark, home of Lego headquarters — who took a keen interest in our Aisys sculpture," says Mr. Marren. "It was fun to learn that so many had heard about the sculpture through word of mouth and sought out the GE Healthcare booth to see what the buzz was about." — Mark McGraw |
Maquet FLOW-i from Maquet
Along with advanced monitoring and respiratory controls, this new anesthesia delivery system features the company's Maquet Volume Reflector, which is a re-breathing device that allows partial recirculation of exhaled gases. This feature helps minimize waste and unnecessary use of anesthetic agents, which could mean saving the department money on anesthetic gases and vapors. The FLOW-i is also available in 3 models. The C20 model has extra storage capabilities, the C30 is electronically height-adjustable and the C40 can be ceiling-mounted. These options make it possible to reposition the control panel and patient monitor, depending on what type of procedure you're performing.
Stimuplex Ultra from B. Braun Medical
For a surgeon performing a peripheral nerve procedure, the most difficult part is seeing if your needle is in or out of the plane. With this type of insulated echo-genic peripheral needle, you can see the needle getting close to the nerve. For single-shot nerve blocks with nerve stimulation and ultrasound, the Stimuplex Ultra helps visualize and differentiate the needle shaft from the tip at steeper angles, using the same tactile feedback and overall needle feel as B. Braun's Stimuplex A. The ability to see the nerve gives the surgeon greater confidence, leads to less nerve injury and results in greater success.
GlideScope AVL Reusable video laryngoscope from Verathon
The GlideScope is a proven device for handling difficult intubations. The AVL Reusable video laryngoscope is an important advancement in this product line, in terms of adding a digital color monitor and digital camera to provide better visualization of the patient's airway. The digital monitor and camera offer a consistently clear view, which helps make intubation quicker. The AVL Reusable also offers real-time recording, which is useful in confirming tube placement.
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ALSO ON DISPLAY |
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3 Products for More Efficient Anesthesia Christie displayed the VeinViewer, which makes it easier for the nurse starting the IV to find the veins, and makes the process less nerve-wracking for patients as well. AVIN (Active Vascular Imaging Navigation) lets VeinViewer "see through the skin," viewing veins, bifurcations, valves, real-time refill/flushing of vessels and complications such as hematomas from an accidental puncture, thereby improving the outcome of the total vascular access procedure, not just the needle stick. Karl Storz Endoscopy-America unveiled the C-MAC Pocket Monitor video laryngoscope, a small, flexible and mobile laryngoscope developed for preclinical and clinical use, with a high-resolution, 2.4" LED display that shows a high-contrast picture. Micropore's Eclipse CO2 is a solid lithium-based cartridge that adsorbs the least volatile anesthetic agent, resulting in target anesthetic concentration being achieved quicker and more consistently, as well as faster washouts, which can save time while using less anesthetic agent. — Mark McGraw |
SonixTablet with GPS from Ultrasonix
Many anesthesiologists haven't "grown up" using ultrasound, and a tool such as this can increase their success and confidence with respect to needle placement. The Sonix-Tablet's GPS ultrasound guidance technology is designed to help clearly predict and see the needle's trajectory during invasive procedures. The guidance system is intended to show the user whether the needle is in plane or out of plane with the transducer, saving time with difficult cases and reducing the learning curve for clinicians new to ultrasound. With a simple touchscreen display, users can easily customize what they see on the monitor.
U-Blok from Interson Corporation
Another interesting ultrasound product on display at ASA was the U-Blok. This portable anesthesiology ultrasound system provides tablet-based ultrasound imaging, and is designed to more effectively manage regional blocks as well as acute and chronic pain management. The system's portability is a big improvement over many ultrasound machines, which are relatively bulky. Intended to be Internet-friendly, the standalone system also features integrated and automatic e-claim filing of patient information directly to the insurance provider. This is an important feature, as billing companies or insurance companies require an image for reimbursement. Having digital images ready to send saves time and paper, and leads to quicker reimbursement for cases.
Cable Jacketz from GFMS
The medical hoses, cables and cords that lie around many ORs are just waiting for staff to trip over them. The Cable Jacketz housing system is a useful tool for removing these potential hazards from your OR floor. It's always a good idea to better organize the cables in your surgical suite. This system is available in custom-sized lengths and diameters, which offer some flexibility in terms of accommodating your specific OR setup.
Innovian Anesthesia 4.0 from Dr??ger Medical
Digital anesthesia records are only going to become more common in the OR. This clinical anesthesia information management system reduces the need for paper charting in the perioperative environment. Required data fields, time stamps and electronic signatures provide a comprehensive record, making it easier for users to demonstrate regulatory compliance. In addition, automatic charge capture helps facilitate reimbursement opportunities, and the system's ability to provide a complete patient record helps ensure your center receives adequate reimbursement for the procedures you perform.
Vapor-Clean filters from Dynasthetics
Malignant hyperthermia cases are rare, but anesthetists need a clean machine when MH does occur. Depending on the agent and machine, published washout times have historically ranged from 27 to 104 minutes. This new device provides a clean machine in less than 90 seconds, which is critical for potential MH cases. Even trace amounts of vapor released from anesthesia machines can be harmful for patients susceptible to malignant hyperthermia. The Vapor-Clean activated charcoal filter reduces exposure of desflurane, sevoflurane and isoflurane molecules to less than 5ppm, preventing them from reaching the patient for an entire case lasting up to 12 hours.
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